Nearly 10% of cancer survivors smoke, despite risks

Kim Painter, Special for USA TODAY 11:06 p.m. CDT August 5, 2014

A woman takes a cigarette break in downtown Chicago. New research shows that nearly 10% of long-term cancer survivors are smokers, despite higher risks of recurrences and other health problems.(Photo: 2006 photo by Julio Cortez, AP)

Nearly one in 10 long-term cancer survivors play with fire by continuing to smoke, a new study shows.

Smoking rates are especially high among those who had cancers strongly linked to smoking, such as lung and bladder cancer, say researchers who questioned nearly 3,000 survivors nine years after diagnosis. The results are published Wednesday in the journal Cancer Epidemiology, Biomarkers & Prevention.

The study suggests "just how difficult it is to quit," even in the face of dire health consequences, including cancer recurrence, says lead author Lee Westmaas, an American Cancer Society researcher.

The researchers assume almost all of the smokers had smoked before their cancers, Westmaas says. They estimate that one-third of the people who were smokers when diagnosed with cancer quit, while two-thirds continued.

The overall smoking rate among cancer survivors was 9.3% — about half the rate found among all U.S. adults. Bladder and lung cancer survivors had rates of 17.2% and 14.9% respectively. Lower rates were found in survivors of melanoma (7.6%) and colorectal cancer (6.8%).

Those who smoked tended to smoke heavily: 83% smoked daily, inhaling an average of nearly 15 cigarettes a day. Smoking was more common among women than men and it was linked with low education and income. It also was more common among those who had experienced a cancer recurrence than those who had not.

"I was surprised by the numbers being so high," says Roy Herbst, chief of medical oncology at Yale University. Herbst was not involved in the study but chairs a committee on tobacco and cancer for the American Association for Cancer Research, which publishes the journal in which the study appears.

Smoking raises the risk of cancer recurrence but also makes some cancer therapies less effective and can impair healing after surgery, Herbst says.

He says there are smoking cessation programs tailored to cancer patients at many major hospitals, but "clearly we need to do better."

Counseling, medication and other approaches can help people with cancer or a history of cancer quit, but not enough people may know about or have access to them, Westmaas says.

In the study, 47% of cancer survivors said they were planning to quit, another 43% said they were "not sure," and 10% said they had no plans to quit.

"It seems like a lot of them do want to quit," Westmaas says. "But we think that the level of addiction they have and the lack of knowledge about available treatments is another issue."

Help for anyone who wants to quit smoking is available from state "quit lines" at 1-800-QUIT-NOW (1-800-784-8669) and from other telephone and text counseling services listed at smokefree.gov. The cancer society also has tips at cancer.org.